This application is a competitive renewal of the Training Grant Research Training in Diabetes and Endocrinology, which would represent years 42-46 of the first, and longest-running, T-32 grant at the University of Pittsburgh. The longevity is a testament to the success of the program in providing postdoctoral Trainees with the research/career skills necessary for developing independent academic careers. Over that time period, the research landscape has changed dramatically, and this training program has adapted to compliment the changes. One notable and relatively recent change is the increased complexity of medical research, requiring cross-discipline integration of research programs. This change necessitates that researchers operate in an environment that provides a thorough grounding in the translational focus of medical research. Added to this is the need for ever greater competency in the ancillary skills that are required to compliment the core research skills - including project, group, and multi-team collaboration management, grant writing, public presentations, transitioning to independence, and others. Historically, these skills were often learned `on the fly', but now require a more structured approach. Thus, a major goal of this renewal was to further strengthen an outstanding program with an eye to the aforementioned evolutions, so that our Trainees are continuously immersed, through hands-on-mentoring, peer-to-peer interactions, research experiences, didactic classes, education workshops, and presentation opportunities, in a truly integrated translational research training program. At a practical level, this is reflected in (i) outstanding research opportunities that are centered on three research hubs (basic, clinical, and public health); (ii) exceptional training faculty with expertise in basic, clinical and public health research; (iii) access to a range of didactic course, workshops, and education experiences, including masters and certificate programs, that buttress and compliment research opportunities, and in many cases emphasize translational themes; (iv) structured career development courses that will impart skills ranging from managing group projects, to presentation skills, through the K-to-R grant transition; (v) a continuous assessment program for Trainees, reinforced by an Individual Career Development Plan, a 3-person mentoring team, and yearly progress evaluations by the Training Committee that focuses on the individualized professional development of Trainees, and (vi) a program management that will efficiently oversee the ever-increasing complexity of research training in medical research. Our expectation is that we will continue to train 4 postdoctoral fellows per year, with a balanced mix of MDs and PhD's, and will offer two years of support to each Trainee. Of the 11 Trainees that graduated from the Training Program during the current cycle of this grant (6 MD and 5 PhD), 7 applied for or received funding while Trainees, or subsequent to the completion of their training. Moreover, these 7 are currently active in research or research related careers. Also, 2 of the 4 Trainees who did not apply for funding remain active in research careers, which we hope will be reflected in applications for grant funding in the future. Fourteen peer-reviewed first author publications (3 are currently in review) have been produced by these Trainees to date, and 12 first author abstracts have been presented at national meetings. Eight Trainees obtained faculty positions, and 3 are in further training.